[Application of contact laser scalpel in thoracic surgery].

The authors have carried out 296 transthoracic and endoscopic YAG-laser operations in various diseases of bronchopulmonary system. Sapphire and quartz applicator-tips were used as a contact scalpel. The procedures of laser operations with the use of the contact mode are described in detail and comparative evaluation of both types of thermal applicator-tips is given.

[Combined laser therapy of diabetic gangrene of the lower limbs].

Results of treatment of 130 patients with diabetic gangrene, whom the lower limb amputation on various levels was conducted, are adduced. In 58 patients the surgical treatment together with combined use of laser was conducted: intravascular irradiation of blood, high-powered laser Application while amputation performance and after it--percutaneous irradiation of amputation stump. Laser use promotes the improvement of immediate results of treatment and decrease of its duration.

[The diagnostic and therapeutic potentials of thoracoscopy in thoracic surgery].

Within a decade, the authors performed 484 thoracoscopies in patients with spontaneous pneumothorax, open and closed thoracic trauma, pleuritis, pleural empyema. High diagnostic possibilities of the method permitted to choose a rational therapeutic tactics. In 228 cases, different endothoracic interventions under the guidance of a thoracoscope were performed.

[The use of laser radiation in the treatment of complicated chest trauma].

The results of treatment of 84 sufferers with a complicated thoracic trauma, using irradiation of the YAG-neodymium, argon, helium-neon and arsenide-gallium lasers, are presented. The techniques for the use of lasers for photocoagulation of defects of the lung and thoracic wall through a thoracoscope, endobronchial laser therapy and laser puncture is described. The expediency to use laser irradiation in the complex of treatment of a complicated thoracic trauma is shown.

[Surgical treatment of complicated bullous pulmonary emphysema].

The paper provides the results of treating 118 patients aged 16 to 78 years who had complicate bullous emphysema. The most frequent complication was spontaneous pneumothorax (n = 107). Chronic respiratory failure was observed in 8 patients with bullous formations occupying 1/3-2/3 of the hemithorax volume.

[Use of laser irradiation in the treatment of lung tumors].

Endobronchial laser therapy was employed in the complex of treatment of 90 patients with tumorous pulmonary diseases. An LG-75 helium-neon laser with the output power of 20 mW was used. A pronounced therapeutic effect was noted in 75 patients.

[Emergency thoracoscopy in the diagnosis and treatment of complicated chest injury ].

Emergency thoracoscopy was undertaken in 111 patients with complicated closed chest trauma and in 67 persons with penetrating knife wounds of the chest. Thoracoscopy in patients with closed chest trauma revealed pneumohemothorax in 53, pneumothorax in 42, and hemothorax in 10 cases, in 4 patients the hemothorax was coagulated. Penetrating injuries were complicated by pneumohemothorax in 30, by pneumothorax in 21, and by hemothorax in 16 cases.

[The use of the neodymium-YAG laser in thoracic surgery].

The technique of use of a neodymium YAG-laser for surgical treatment of diseases of the lungs and pleura in 25 patients is described. The experience accumulated is indicative of good aero- and hemostatic properties of the laser, which permit to reduce the incidence of postoperative complications.

[Diagnosis and treatment of complex closed chest injuries].

The results of treatment of 256 patients with complicated closed chest injury are discussed. Multiple fractures of the ribs were found in 178, closed pneumothorax in 127, pneumohemothorax in 71, isolated hemothorax in 55, and rupture of the diaphragm in 3 patients. Most patients received nonoperative treatment, 5 patients (6.

[Use of neodymium YAG laser in endoscopic hemostasis in thoracic surgery].

YAG-laser radiation was used for endoscopic hemostasis in 33 patients with bleeding endobronchial carcinomas and in 4 patients with chest injury complicated by bleeding from wounds of the lung and chest wall. For conducting laser photocoagulation, the authors prefer a rigid bronchoscope and a thoracoscope and pulsed laser radiation with a power of up to 40 Wt. As the results of treatment, hemostasis was achieved in 24 patients with lung carcinoma and in 4 patients with trauma of the chest.

[Hazards and complications of endoscopic laser operations in thoracic surgery].

The danger and complications of endoscopic operations with the use of IAN- and argon lasers are characterized. Among 327 bronchoscopic laser interventions carried out for tumors of the respiratory tract, 7 (3.1%) were attended by complications in the form of perforation, hemorrhage, and laryngospasm.

[Use of endoscopic laser and electrosurgical interventions in thoracic surgery].

A total of 320 endoscopic yttrium-aluminum-garnet laser and electrosurgical operations were carried out on 186 patients with tumors of the trachea and bronchi. Most operations were performed with the use of Friedel's respiratory bronchoscope and general anesthesia. Optimization of the methods of endoscopic laser and electrosurgical interventions made it possible to achieve a positive clinical result in the form of recanalization of the stenosis and arrest of bleeding in 143 (75.

[Diagnostic and therapeutic thoracoscopy in spontaneous and traumatic pneumothorax].

224 thoracoscopies were performed to patients with spontaneous and traumatic pneumothorax. Curative thoracoscopy (diathermocoagulation, laser coagulation) was performed in 93 patients, in 42 patients medical glues were used. Out of 93 patients who had been subjected to curative thoracotomy endoscopic operations gave no effect in 5 patients only.